| NPI | 1013461243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK O SULLIVAN Chief Medical Officer 856-625-8563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NJ 37F100176500) |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2016-08-04 |